June 2, 2010

The Other White Powder

An Institute of Medicine (IOM) report on salt isn’t normally where you’d go to discover a muscular new approach to food regulation. But Fox News and the Salt Institute were not wrong to call last month’s report nanny statish. What it proposes is a revolution in the relationship between the government and the food we put on our plates. For one thing, the IOM report calls for the Food and Drug Administration (FDA) to clamp down on salt in the absence of much evidence that consumers want the agency to do so. Though the aim is to reeducate us so that we’ll realize that we do want such intervention, the main idea is for regulators to sidestep our desires and strike at the producers said to be salting us to death.

Do we really need the government to cut down on salt for us? The report paints a dark portrait of food-processing mills and satanic kitchens that certainly seems to justify drastic action. The authors start with the health consequences of salt overconsumption: high blood pressure; hypertension; 100,000 deaths per year; $18 billion in health care costs. Then, they give us the big picture. Competition is driving manufacturers to put ever more outrageous quantities of salt in their concoctions, for the saltier a soup or piece of cheese, the better it tastes and the smoother it feels, and the more likely it is to outsell other brands. Meanwhile, consumers are too easily hooked on saltiness to keep from poisoning themselves. Therefore, the report concludes, the FDA should enforce limits on salt, and, by tightening these limits over time, retrain our palates so that we don’t crave saltiness as much. (It seems that it takes about three months for taste receptors to adjust to a less salty diet.)

We’re so used to thinking of salt as, on the one hand, only vaguely bad for us—certainly not as bad as bisphenol A—and, on the other hand, so indispensable that it may come as a shock tohave it re-categorized as an addictive substance. Salt has been a force for good throughout human history. Ever since our diet shifted away from game, which is naturally salty, toward grain, fruit, and vegetables, which aren’t, we have needed to add salt to our diet or face low blood pressure. “The very name of salt breathes of health,” writes the food historian Waverly Root. “It comes from the Roman god of health, Salus, who gave to the English language such words as ‘salutary’ and ‘salute’ ... not to mention ‘salvation.’” Salt preserves the perishable and flavors the bland. The search for better ways to extract salt from the sea and the earth and distribute it has led to engineering marvels, public works, trade routes, and the invention of gastronomic staples to function as salt transport and delivery mechanisms, including salt cod and salami (whose name also comes from the word for salt).

What turned such a benevolent condiment into a toxin? Or, to use the language of food regulation, how did salt go from GRAS (“generally regarded as safe”) to potentially harmful additive? The answer is a cautionary tale about what happens to your food when you cede control of its preparation. The story begins with the most profound change to have occurred in Western society in the twentieth century, which is the entry of women into the workforce. The explosion of both the packaged-foods industry and the chain restaurant business can be traced to the advent of dual-career and single-parent households, both of which labor under severe time constraints. Around 30 years ago, pressed for time and more flush with cash, we became less willing to perform the unpaid labor of food preparation and more eager to have food made for us. Thirty years ago is also when researchers spotted an uptick in numbers of obese Americans, the first sign of what is now described as an obesity epidemic. It turns out that, when we buy meals rather than make them, we generally wolf down larger portions (which manufacturers and restaurateurs prefer to sell to us, because bigger quantities yield more revenue) of saltier, fattier foods (which manufacturers and restaurateurs also like to sell to us, because we’re more likely to eat them whether we’re hungry or not). When dinner consists of a Swanson’s Hungry-Man XXL carved turkey meal, for instance, we may not realize that it contains nearly twice the recommended daily amount of salt—5,410 milligrams of it.

Salt is only a part of this story. One-third of it, to be exact. In his exposé of the food industry, The End of Overeating, former FDA commissioner David Kessler depicts a Fritz Lang-like world of secret laboratories in which industrial food scientists experiment with an unholy troika of “hedonic” ingredients—fat, sugar, and salt. Their goal is to create what he calls “hyperpalatable foods” that function as “supernormal stimuli.” (Conjure up a Cinnabon cinnamon roll, and you’ll have the idea.) According to Kessler, we’re biologically designed to pay attention to, and get excited about, unusual and outsize sources of pleasurable stimulation, such as dishes stuffed with sugar, fat, and salt in quantities greater than any we’ve ever encountered before. These, in return, have the power to “alter the landscape of the brain.” Hyperpalatable foods deliver a jolt to the neurotransmitter that releases dopamine; after a time, dopamine neurons fire even at the suggestion of such food. That is the neurological process underlying craving. Once we’ve eaten what we crave, the brain floods with opioids, which bring relief. This dopamine-opioid release pattern is the basis of our food habit, which responds to environmental cues (pictures, ads, time of day) and not just physiological ones (hunger).

By means of “conditioned hypereating,” in Kessler’s words, the food industry has hooked us on its unhealthy products nearly as surely as the tobacco industry did on cigarettes, though possibly with less understanding of the physiology involved. He proposes a multipronged counterattack against “big food”: posting calorie counts in restaurants, education campaigns, better labeling, and much closer regulation and surveillance of the food industry.

That is the intellectual matrix from which the IOM report emerges. The time-pressed, information-overloaded consumer needs the government’s protection against the food industry’s scientists, market researchers, and lobbyists. Moreover, as the report stresses, the FDA would not be telling people to put away their salt shakers. It turns out that table salt accounts for only 5 percent of sodium consumed, and, when people salt their own food, they put in less than one-fifth the amount that industrial processors do. If all you do is salt at the table, rather than at the stove, you add even less: When salt crystals cling to the surface of a food, they yield a sense of saltiness to your tongue more readily.

Nonetheless, if you’re a food lover or cook and try to imagine how, exactly, the new salt regulations will be put into practice, it’s hard to feel a surge of pleasant anticipation. The bulk of the recommendations involve “big food”—food processors, chain restaurants, and other mass operations such as the school lunch program and the military. But non-chain restaurants oversalt, too; how, exactly, will the line cook at the corner bistro with the heavy hand be forced to comply with the code? Consider, too, the question of which foods should be desalted. Soda or children’s cereal? No problem. Olives? Hmm. The report put off recommending specific food categories to be exempted. Some committee members apparently weren’t sure any foods should be completely exempted, because, if any supersalty foods were left in our diets, our palates might fail to be retrained.

In addition, reeducation programs focused on a single ingredient almost always confuse people. No matter how careful education campaigns are to stress that salt is essential to life in small doses, some Americans will demonize the condiment, rather than its industrial overuse. Food psychologist Paul Rozin has shown that a substantial minority of test subjects, regardless of class or educational level, respond to a confusing barrage of nutritional information with “a monotonic mind,” “categorical thinking,” and the fear of contagion. That is, they reason that, if a lot of something is bad for you, a little of it must be too.

The real problem with the salt-reduction campaign, though, is that it doesn’t go far enough. We can’t change the way Americans eat simply by scaring them in turns about fat, then bisphenol A, then salt, then presumably sugar. Nor is regulating salt the first step toward regulating fat and sugar. If anything, the FDA is likely to expend political capital on salt, then be unable to get Americans’ attention to push through reforms on fat and sugar. We need to stop ingesting all these substances in ludicrous amounts. To do that, we need information even more than we need regulation—but we need our information to be radically honest. We need tobe taught not just what’s in processed food, but how historically anomalous its manufacture and our consumption of it are. We need to understand the mechanisms that addict us to it. We need to relearn how to prepare real meals, and we need to start rethinking the social dynamics of that chore (it can’t just be up to wives and mothers anymore). It’s pretty hard to imagine the government conducting that education campaign, but, 20 years ago, it may have been just as hard to imagine the “truth campaign” that exposed the tobacco industry’s marketing techniques and the transformation of social norms that made it déclassé to smoke. As the former regulator Kessler puts it, “We’ve learned from the major public health battles of the past that while legislation and regulation play a major role, the greatest power rests in our ability to change the definition of reasonable behavior.”

Judith Shulevitz is the author of The Sabbath World: Glimpses of a Different Order of Time.